Oral Health Status as a Mediating Effect Between Psychosocial Factors and Oral Health-Related Quality of Life

Introduction and aims: While oral health status and psychosocial factors are associated with oral health-related quality of life (OHRQoL), the mechanisms remain unclear. This study aims to investigate their relationships and explore potential mediating effects. Methods: Cross-sectional data were collected from dental examination and psychosocial scales of patients who visited the dental clinic for routine check-ups and/or preventive measures in 2023. All data were analysed using SPSS with the AMOS plugin. Data preprocessing included Little’s MCAR test and multiple imputation. Reliability and validity tests were conducted to optimize the psychosocial scales. The Mann-Whitney U test and Spearman test analysed the differences and correlations between variables. A hierarchical multiple linear regression identified factors associated with the OHRQoL score and identified potential mediating effects. The structural equation model (SEM) supplementarily quantified the mediating effects. Results: 104 adults, with a median age of 59 years, were included. The linear regression results were consistent with statistical mediation by oral health status (periodontal treatment need, plaque control record (PCR), caries treatment need), such that the direct association between psychosocial scores (self-efficacy of tooth-brushing score (SEoTB), self-efficacy of inter-dental cleaning (SEoIDC)) and the OHRQoL score was no longer evident after inclusion of oral health variables. The bias-corrected and accelerated (BCa) 95% confidence interval for the mediating path was −0.102 and −0.011 (P < .05). The mediating effect was −0.055, accounting for 12.6% of the total effect. Conclusions: Higher oral hygiene-related self-efficacy (OHRSE) is associated with better OHRoL, with this association partly explained by more favourable clinical oral health status. Clinical Relevance: These results highlight the potential of combining psychological and oral health management strategies in both individualized treatment and public health programs. By strengthening oral hygiene self-efficacy, clinicians may reduce treatment needs, improve periodontal and caries status, and consequently enhance OHRQoL.